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D. Nikoleishvili *, A. Pertia , G. Khvadagiani , G. Koberidze *Head of Urology Department

Laparoscopic radical prostatectomy for locally advanced prostate cancer – experience of National C enter of Urology. D. Nikoleishvili *, A. Pertia , G. Khvadagiani , G. Koberidze *Head of Urology Department MediClubGeorgia Tbilisi, Georgia.

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D. Nikoleishvili *, A. Pertia , G. Khvadagiani , G. Koberidze *Head of Urology Department

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  1. Laparoscopic radical prostatectomy for locally advanced prostate cancer– experience of National Center of Urology. D. Nikoleishvili*, A. Pertia, G. Khvadagiani, G. Koberidze *Head of Urology Department MediClubGeorgia Tbilisi, Georgia

  2. EAU risk groups for biochemical recurrence of localized and locally advanced prostate cancer

  3. EAU Recomendation 2016

  4. There is no consensus regarding the optimal treatment of men with high-risk & locally advanced PCa The ideal treatment for this patients remains controversial

  5. NCU Database of HRPC Prostatectomies In order to attempt the answer of this question, we retrospectively reviewed our results for performing LRP in disease group of over a 26-months period.

  6. ENDOSCOPIC-LAPAROSCOPIC RADICAL PROSTATECTOMY EERPE IN NATIONAL CENTER OF UROLOGY First EERPE in Georgia 27.07.2010 First within Caucasus and Central Asia 524 operations

  7. Patients Distribution • 524 patients LRP - 65 month period from 2010-2016 119 (22.7%) had Locally advanced disease • All patients were staged by pre-operative MRI or CT and isotope bone scanning • Age at surgery, median (IQR) - 65.0 (61.0–69.5) • BMI, median (IQR) - 30.7 (27.0–34.3)

  8. Pre- and perioperative data

  9. Pre- and perioperative data

  10. Pre- and perioperative data

  11. Lymph Node & positive margins

  12. Postoperative Complication

  13. Retrospective Review – Locally advanced LRPNational Center of Urology 2010-2016

  14. Results • No cases were converted to open surgery • The 1-yr urinary continence recovery rate = 72% • Median (IQR) follow-up after surgery = 23.5 (19.2–26.4) mo. • Biochemical recurrence – 35 (29.4%) • Clinical recurrence – 8 (6.7%) • Cancer-specific mortality – 7 (5.9%) • BCR-free survival rate – 70.6% • CR-free survival rate – 93.3%

  15. RECOMMENDATIONS OF EAU

  16. Conclusion Todate,thereisnoreasonthatasurgeonobtainingexcellentfunctionalandoncologicresultswithRRPshouldchangetoadifferentapproach;alternatively,surgeonsobtainingsuboptimalresultsmightimprovethembyshiftingtoadifferentapproach.Duetothelimitationsofthecurrentlyavailableliterature,furtherprospective,comparativestudiesareneeded.

  17. SHAPE & SIZE OF PROSTATE 185cc apex Middle lobe

  18. MIDDLE LOBE SIZE 120cc 4X4cm apex Middle lobe

  19. CONCLUSION The low morbidity rate, good functional and early oncological results serve as evidence that laparoscopic prostatectomy is an effective treatment for patients with locally advanced disease.

  20. 3D SYSTEM Olympus Unveils Articulating HD 3D Laparoscopic Surgical Video System

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